Melinda Gates on providing contraception for women worldwide

Philanthropist Melinda Gates looks on during the annual Clinton Global Initiative September 21, 2010 in New York City. She discusses why her latest effort is to provide contraceptive options for women around the globe. - Mario Tama/Getty Images

Jeremy Hobson: The proportion of foreign aid that goes to family planning in developing countries has fallen dramatically in recent years as more and more money is being spent on other health needs.

Well, tomorrow in London there's going to be a major conference that aims to bring the focus back to family planning. It's being organized by the British government and the Bill and Melinda Gates Foundation.

And we are pleased to be joined this morning by Melinda Gates herself. She's with us from Seattle. Good morning.

Melinda Gates: Good morning.

Hobson: Well, your latest effort is aimed at providing contraception to women around the world. Why that issue?

Gates: We know today that 200 million women around the world would like to have access to contraceptives, and don't. And we know that it's life-transforming for them and their families if they can plan the timing and the spacing of the births of their children. So I think we should give them the simple tools that we have in places like the United States or the U.K. The time is now.

Hobson: Do you have any problem with the fact that contraception is still pretty controversial? Even in this country, we just had a big brouhaha over whether insurers should provide contraception for people. Do you have any problems with religious organizations in some countries for that?

Gates: You know, I think we've made contraceptives really controversial, and we shouldn't. And what's that meant for women all over the world is that we've taken it off the global health agenda. So now we've got to put it back on the global health agenda, because most Americans -- 99 percent of women -- say they use, in the U.S., contraceptives.

So we're talking about giving these tools to women all over the world. When I travel in places like Africa, you would be amazed at what women know about contraceptives and say, "Why is it that I could get them at my health care facility just a few months ago, and now I go in for that D-Provera shot, and I can't get it any longer? I don't know when I can get another one, and I'm not ready to have another child. I have this young one that I can't even feed today." So we need to not make it controversial so we do the right thing for women all over the world.

Hobson: What about the issue of education? I've seen some of the studies that show that the birth rate in many places is tied directly to the amount of years of education that a women has had.

Gates: Absolutely. And so we do need to educate women around the globe. We also need to educate them about contraceptives, so that they know what's available in their community and they can then decide what they want to do. They need to have options so they can decide what makes sense for them.

But we know just a little bit of education for women -- she wants to bring down her birth rate, because what she knows is if she can time those births, she can save her own life, and then she has a chance of feeding and educating her children, which puts her whole family on a new trajectory for their life.

Hobson: How do you decide to get involved in an issue like that? There are so many things you could obviously do to help -- and you do do many of them -- but how do you pick them? How do you pick the issues?

Gates: Well you know, I've been traveling now for over a decade for the foundation -- places like Bangladesh, India, I go to Africa many times a year. And as I would go out and talk to women about their needs and their desires for their families, I go out to talk to them initially about vaccines and other life-saving treatments. But what kept coming back over and over again from women was, "Why can't I have a contraceptive? I want to have fewer children, and yet I don't have a tool available. I used to be able to have one, and now I don't. And why is that in my country?"

And so this has just been resonating for us for quite some time. Bill and I actually started the foundation working both on vaccines and on contraceptives. We got away from contraceptives for a little while, and now we've realized it's really got to be back on the agenda. So I'm very enthused to make sure we can give women this access.

Hobson: Do you feel some responsibility as one of the most powerful women in the world to focus on issues that perhaps men don't think as much about?

Gates: I do, because I think the right thing to do in terms of giving families options, you have to put the tool in the hands of a woman. And I think unless a woman comes out and says, "This is really, really important and we have to do it from the bottom up; we have to let women plan their families." I do think it takes a woman to stand up and say, "This is important." Otherwise, we've seen what's happened the last 20 years -- the tools haven't gotten out there, and so it's time.

Hobson: Why do you think that in 2012, there is still such a lack of women in high-ranking positions, especially in the world of business?

Gates: I think that's a complicated issue, and I think it's different depending on where you go -- whether it's in Europe or if it's in the United States. But what I would encourage women to do is to use their voice -- and when they see an issue, stand up and speak about it. When they see another woman they can mentor or sponsor into a role, I think that's really important for women to do. I think you see women doing that more, and I think the more we see that, I think you'll start to get this positive momentum of more women actually climbing into some of those positions. And we are seeing some progress, but certainly not enough.

Hobson: Did you personally ever struggle with a work-life balance, or feel that you couldn't advance in the way that a man could?

Gates: I think all women struggle in the United States if they have children and they're working; I'm sure all women struggle with that work-life balance. And certainly, I do. The foundation has unique challenges because I travel around the globe and obviously, if you go to a place like Africa or Bangladesh, you don't just drop in for a couple of days.

But the nice thing is that this work allows me to do both, and I enjoy it so much. What's really made me passionate are the women I meet on the ground and realizing that I can give voice to them, to the issues that they really struggle with. I mean, you want to talk about a real life struggle? Can you feed your children? Can you educate your children? And I'm so passionate about giving voice to them that it's worth working on.

Hobson: What do you think that organizations like your foundation can do that governments can't or that individuals or businesses cannot?

Gates: I think all a foundation can do is really be a catalytic wedge. We can shine light on the issues where you can have really incredible impact with foreign aid and with dollars. We can take some of the innovation and the risk out of the equation so we can try new innovative tools -- whether it's a vaccine; whether it's a new contraceptive tool for women. We can start to pilot those and scale those up. But ultimately, it takes governments to scale these up on a widespread basis. But we can bring all of those partners together around a global issue and coalesce the field to move a goal forward.

Hobson: It's such a unique thing to do, to go around the world and help people in this way, in so many different capacities. I wonder: Is there something you can remember back to, when someone that you did not know, came in and helped you in a big way?

Gates: Well, I've had many people in my life, but yes. I think one of the greatest opportunities in the United States is an incredible education, and so I had many teachers along the way, but one in particular -- a math and computer science teacher who in high school said to me: "You can be good in math, you are good in math. I'm going to get you a computer." She set me on the way of giving me confidence and knowing that a girl can be great in science and math. And that was important later for what I did in college and now what I do at the foundation.

Hobson: You mentioned that you've been to a lot of countries -- what country do you think needs the most help right now, that you've been to?

Gates: I would say that there are a whole host of African nations that could use help. What I'm seeing though is a lot of hope on the ground in Africa because of foreign assistance. I'm seeing an emerging middle class in Africa. But I think unless you get these tools in the hands of women, you're not going to be able to bring down the birth rate, and so I think that becomes very difficult then for a country to manage when you get an enormous population, such as a country like Nigeria. But I'm also seeing huge progress in countries like Ethiopia -- who have a large population, but they're doing all the right things in health for their country.

Hobson: Who would you say is the most inspiring person that you've ever met?

Gates: I would certainly say Nelson Mandela. What he did in South Africa in such an incredible way to help the country move forward. Not only when you watch his speeches, but when you meet him in person, his unbelievable wisdom with how he moved forward in very tricky issues -- that's something that resonates with Bill and me around the foundation. And it took a lot of courage.

Hobson: Melinda Gates is the co-chair of the Bill & Melinda Gates Foundation. Thank you so much for talking with us.